结核性葡萄膜炎患者房水的细胞因子含量研究  

Cytokines levels in aqueous humor of patients with tubercular uveitis

作　　者：程奕喆 呼风 王茹 董喆[1] 苗景鹏[1] 李倩[1] 陈春丽 王戈 管文雪 彭晓燕[1] Cheng Yizhe;Hu Feng;Wang Ru;Dong Zhe;Miao Jingpeng;Li Qian;Chen Chunli;Wang Ge;Guan Wenxue;Peng Xiaoyan(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing 100730,China;Department of Ophthalmology,Xi’an People’s Hospital,Xi’an Fourth Hospital,Shaanxi Eye Hospital,Xi’an 710004,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心、北京市眼科研究所、眼科学与视觉科学北京市重点实验室,100730 [2]西安市人民医院(西安市第四医院)陕西省眼科医院眼科,710004

出　　处：《眼科》2023年第2期135-141,共7页Ophthalmology in China

基　　金：首都卫生发展科研专项(首发2018-2-1081);北京同仁医院重点医学专业发展计划(trzdyxzy201801);国家自然科学基金(82171073)。

摘　　要：目的分析和比较不同类型结核性葡萄膜炎(TBU)患者的眼内细胞因子含量。设计单中心回顾性病例对照研究。研究对象2018年8月至2022年5月于北京同仁医院眼科诊断为TBU的患者26例(26眼),其中,结核性匍行样脉络膜炎(TBSLC)6例,结核性后部葡萄膜炎及全葡萄膜炎(TPU-TBP)8例及结核性视网膜血管炎(TRV)12例。对照组为老年性白内障患者27例(27眼)。方法所有患者均使用1 mL注射器针头吸取前房水50~100μl。用流式细胞微球捕获芯片技术检测细胞因子(VEGF、IL-6、IL-8、IL-10、bFGF及VCAM-1)的含量。比较TBU与对照组及三种类型的TBU组间细胞因子含量差异,并比较不同玻璃体混浊程度、TRV血管炎不同程度者的细胞因子含量,并进行细胞因子含量与发病持续时间的简单线性回归分析。主要指标房水中VEGF、IL-6、IL-8、IL-10、bFGF及VCAM-1的含量。结果TBU组房水中细胞因子IL-6、IL-8、IL-10、bFGF和VCAM-1的表达显著高于对照组;VEGF的表达水平在TBU组与对照组中无统计学差异,TPU-TBP组的VEGF、IL-6、IL-8和VCAM-1表达水平显著高于TBSLC组(P均<0.05),TRV组的VEGF表达水平显著高于TBSLC组(P=0.02),而TPU-TBP与TRV组中各细胞因子的表达水平无统计学差异。VEGF、IL-6、IL-8、IL-10与VCAM-1的表达水平在严重玻璃体混浊患眼显著升高(P<0.05),而不同严重程度的TRV患眼细胞因子表达水平无统计学差异。bFGF,IL-6,IL-8和IL-10的表达水平与发病持续时间呈正相关(P<0.05)。结论TBU的不同亚型(TBSLC、TPU-TBP和TRV)中的细胞因子含量存在差异,表明其存在不同的炎症机制。玻璃体混浊程度及TBU的发病持续时间从侧面反映了TBU的炎症程度。Objective To access the cytokines in aqueous humor(AH)of three entities of tubercular uveitis(TBU),including tubercular serpiginous-like choroiditis(TBSLC),tubercular posterior uveitis and tubercular panuveitis(TPU-TBP)and tubercular retinal vasculitis(TRV).Design A case-control single-center retrospective study.Participants Twenty-six patients with TBU(including six patients with TBSLC,eight patients with TPU-TBP and 12 patients with TRV)were included and 27 patients with senile cataract were enrolled as the control group.Methods Their medical records and imaging data were reviewed and collected.AH samples were obtained at the initial visit or during cataract surgery.Data on the aqueous humor inflammatory cytokines were compared among the groups.The relation between the AH cytokine levels and some clinical characteristics was assessed.Main Outcome Measures Level of VEGF,interleukin-6(IL-6),IL-8,IL-10,basic fibroblast growth factor(bFGF)and vascular cell adhesion protein 1(VCAM-1).Results The expression of IL-6,IL-8,IL-10,bFGF and VCAM-1 in patients with TBU were significantly higher(all P<0.001)than that in control.VEGF,IL-6,IL-8 and VCAM-1 were significantly higher in TPU-TBP than in TBSLC(all P<0.05).VEGF was significantly higher in TRV than in TBSLC(P=0.02).No statistically significant differences were found between TPU-TBP and TRV.The expression of VEGF,IL-6,IL-8,IL-10 and VCAM-1 were significantly higher in patients with severe vitreous opacity(all P<0.05),and no statistically significant differences were found in cytokines in TRV with different severities.The linear regression results showed a positive correlation between the expression of bFGF,IL-6,IL-8 and IL-10 and the interval time from onset to AH acquiring(P<0.05).Conclusions The different inflammation mechanisms may be involved in the three entities of TBU.The degree of vitreous opacity and the duration after onset could reflect the level of intraocular inflammation.

关 键 词：结核性葡萄膜炎 脉络膜炎 细胞因子 聚合酶链式反应 视网膜血管炎 

分 类 号：R773[医药卫生—眼科]